10 One adverse event that also occurred was the discovery of an incorrect patient identification band during a preoperative check. 10 Equipment problems, hypothermia, cardiovascular events, and delays in transport were the adverse events identified. These factors should be considered when facilities develop or revise policies for the intrahospital transport of the non-ICU patient and competency requirements for unlicensed hospital personnel involved in patient transport.Ī six-month prospective observational study with a concurrent retrospective chart audit revealed 66 adverse events among 290 intrahospital transports of critically ill patients from the emergency department (ED) to the ICU, including some admissions via the operating room or after a computed tomography (CT) scan. 6 In the absence of specific guidelines for the intrahospital transport of the non-ICU patient, contributing factors to Serious Events relating to transport of critically ill patients may be applied to non-ICU patient transport events. ![]() 1-3,6,9 The clinical literature yields few peer-reviewed articles, guidelines, or standards for intrahospital transport of non-ICU patients. Patient Transport Issues Submitted to the Authority, May 2004 through September 2008 Ĭurrent research and guidelines focus primarily on the outcomes or equipment-related factors in the intra- and interhospital transport for Healthcare organizations have increasingly recognized the benefits of standardized handoff communication processes when patients are transported from one care area to another. More than 40% of these issues indicated the need for improved communication between healthcare providers (see Table). Facilities identified patient transport Incidents (or near misses) and Serious Events having problems with communication, intravenous lines, monitoring, and other issues in 280 reports. There were 2,390 patient transport-related reports submitted to the Pennsylvania Patient Safety Authority from May 2004 through September 2008. 6 Without practice guidelines, essential elements necessary to complete the safe intrahospital transport of the non-ICU patient may be inadvertently absent from policies, potentially compromising patient safety. 6,8 Facilities have had to develop their own intrahospital transport policies for the non-ICU patient. 6 These patients are typically transported by unlicensed personnel who lack the clinical qualifications or experience to safely monitor these patients. ![]() No formal guidelines exist for the intrahospital transport for the 1,2,4,6 These guidelines suggest that critically ill patients be transported typically by a minimum of two highly qualified and specialized critical care team members who focus on monitoring and ventilatory support. ![]() 1-5 The Society of Critical Care Medicine (SCCM) and the American College of Critical Care Medicine (ACCCM) developed formal transport guidelines for the intra- and interhospital transport of critically ill patients. Intra- or interhospital transports expose patients to periods of potential instability and increased risk for complications, morbidity, and mortality. This article will examine risk reduction strategies to ensure the safe intrahospital transport of the non-ICU patient, including but not limited to the development of an intrahospital transport team for the non-ICU patient, standardization of patient handoff communication tools used during transport, and a robust educational program for unlicensed hospital transport personnel as ways to ensure the accurate exchange of patient information, to decrease the number of adverse events, and to promote optimal care. ![]() Of the 2,390 patient transport reports submitted to the Pennsylvania Patient Safety Authority from May 2004 through September 2008, facilities identified patient transport Incidents and Serious Events having problems with communication, intravenous lines, monitoring and other issues in 280 reports. Healthcare organizations have increasingly recognized the benefits of using a standardized handoff process particularly when patients are transported from one care area to another. Non-intensive care unit (ICU) patient is often performed by unlicensed hospital personnel who frequently encounter patient condition changes requiring immediate intervention.
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